3
Concussion Serious head injuries almost always represent a life-threatening situation Must get athlete to the hospital immediately –Within 30 minutes

4
Signs and Symptoms Altered level of consciousness (LOC) Pain or pressure in the head Tingling or loss of sensation in the extremities Partial or complete loss of movement in any body part

5
Signs and Symptoms cont… Unusual lumps or depressions on the head Blood or other fluids in the ears or nose Profuse bleeding from the head Seizures Impaired breathing Impaired vision

6
Signs and Symptoms cont… Nausea or vomiting Persistent headache Loss of balance Ecchymosis –Especially around the eyes or behind the ears

7
Signs and Symptoms cont… The S/S of a head/brain injury may not be apparent until hours after the trauma occurs Immediate referral to a physician is important for the proper treatment of a serious head/brain injury

8
Primary Assessment Must be able to recognize and interpret the S/S of a head injury If an athlete is unconscious, ALWAYS assume injury to the neck as well

10
Secondary Assessment Assess mental orientation and memory What is your name? How old are you? Where are you? What game are you playing? What is the score? What month is it? Who is president? After 5-10 minutes, ask the same questions again

16
General Concussion Classification Grade II Concussion cont… Post-concussion Syndrome –Difficulty concentrating –Recurring headaches –Irritability S/S may last several weeks Athlete may not return to play until all S/S are resolved

19
General Concussion Classification Grade III Concussion cont… This athlete must be referred to a physician for a thorough examination An intracranial lesion may be present –Results in intracranial bleeding –Causes a gradual increase in intracranial pressure

20
General Concussion Classification Grade IV Concussion Loss of consciousness Referred to as “Paralytic Coma” –Return to consciousness usually within a few seconds or minutes Post-traumatic amnesia Retrograde amnesia Post-concussion Syndrome

28
Epidural Hemorrhage A blow to the head causes a tear in one of the arteries of in the dural membrane that covers the brain Hematoma forms extremely fast –Within 10 – 20 minutes after injury

29
Epidural Hemorrhage Requires surgery to relieve the pressure created by the hemotoma Death or permanent disability may result

30
Subdural Hemmorhage A blow to the head causes a tear in one of the veins located between the dura mater and the brain Hematoma forms slowly –S/S may not be appear until hours after injury

31
Subdural Hemmorhage Commonly occurs following a contrecoup injury May or may not require surgery

32
Intracerebral Hemorrhage A blow to the head may cause bleeding within the brain itself Usually results due to a compressive force applied to the brain Rapid deterioration in neurological function Requires immediate hospitalization

33
Cerebral Hyperemia Vasodilation of cerebral blood vessels following a head/brain injury Causes an increase in intracranial blood pressure Develops within minutes after the injury S/S: headache, vomiting, sleepiness S/S usually resolve within 12 hours after the injury

34
Cerebral Edema Localized swelling of the brain at the injury site Develops within 12 hours after the injury S/S: headache, seizures (occasionally) Cerebral edema may remain for as long as 2 weeks following the injury

36
Criteria to Return to Play: Mild Concussion First Concussion –Return to play if asymptomatic Second Concussion –Must be asymptomatic for 1 week Third Concussion –Terminate season –May play next year if asymptomatic

37
Criteria to Return to Play: Moderate Concussion First Concussion –Must be asymptomatic for 1 week Second Concussion –Must be asymptomatic for 1 month Third Concussion –Terminate season –May play next year if asymptomatic

38
Criteria to Return to Play: Severe Concussion First Concussion –Must be asymptomatic for 1 month Third Concussion –Terminate season –May play next year if asymptomatic